The surgical methods, which were initiated by ayurvedic sages in ancient India , are collectively known by the name of Shalyatantra. The word literally signifies the elimination of irritating factors from the human body. Shalya means cause, which produces pain, or factor, which stimulates irritation, and tantra means the technique by which this cause or factor is done away with.
Ayurved considers our body to be developed from five universal factors . These are earth (prithvi), water (pani), fire (tej), air (vayu) and universal space (aakash). These five factors are collectively known as the panchmahabhootas, which ultimately give rise to the three basic ingredients , the treedoshas (tree = three, doshas = basic constituents or organizations). These are vaat, pitta and kafa. These three components maintain our body`s balance in case of a disproportion in one or more than one of these components, our health degenerates and we become ill. To a certain extent, the medicinal way of treatment or Kayachikitsa can be applied with good results. But at times the disease goes beyond the control of Kayachikitsa and surgical intervention or Shalyatantra becomes mandatory.
While talking about Shalyatantra, the name of the sage-physician Susruta comes foremost in our mind. Susruta was the earliest surgeon to develop cosmetic surgery. His surgical treatment for trichiasis gave birth to some of the modern operative techniques applied to cure this eye disease. Shalyatantra is discussed in detail in the renowned Ayurvedic text Sushrut sanhita, authored by Susruta. Here he gives an exhaustive description of the surgical processes involved in different conditions where surgery is required. Sushrut sanhita explicitly mentions how to deal with Arbuda (different types of tumors), Aghata (trauma injuries), dushta vrana (non healing wounds), Udar (ascitis) and Asthi bhang (Fractures of bones), gandamala (enlarged lymph nodes), Mul- vyadhi (hemorrhoids), Gud-bransh (prolapse rectum), Ashmari (stones), Mutravaodh (retention of urine) and stanarog (breast diseases ) . Moreover, procedures are suggested for dealing with complications during pregnancy and labour or obstructions in the intestinal loop. The surgical instruments used in Shalyatantra were made from natural substances like branches of trees and broad leaves. For ligature the use of a creeper (a climbing plant) was prevalent.
The chief draw back of Shalyatantra was the lack of proper aseptic precautions at that time. Furthermore, the instruments utilized were unsophisticated and often caused much pain to the patient. Inspite of this, the treatment of Shalyatantra was popular because it was able to provide faster relief than the slow process of recovery from medicines or herbs. But, the long foreign rule in India and lack of proper promotional facilities hindered the advancement of Ayurvedic surgery in the middle of the second millennium.
Summarily we can say that despite the drawbacks, Shalyatantra is the root of modern surgery. If we go through these techniques taking into consideration the very fact that they were in practice in India more than 1000 years before, we will certainly recognise the worth of this valuable and indispensible branch of Ayurveda.